Category Archives: Fitness

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Is this Pain really an Injury or not?

4 Steps to Identify if you need to engage in a Formal Rehabilitation Protocol or just Rest

Runners are accustomed to a certain amount discomfort. Training can be hard and uncomfortable at times which is exactly why it’s so rewarding and addicting. It can get a bit confusing when it comes to physical injuries and pain. Most runners have experienced that out of nowhere pain in a foot, knee or hip that had us wondering if we should really keep running. Then just as suddenly as it appeared, it faded away. How about the all too common sentiment: “It takes me 2-3 miles just to feel warmed up from all my aches and pains.”

  • How do we know when it’s time to stop and discontinue our activity or just push through those nagging aches and pains?
  • How do you know if the pain or discomfort you are feeling is something to be concerned about (a true warning sign of an injury) or just common transient stiffness and/or discomfort?
  • Are there really different kinds of pain? How can we differentiate between them?

It can be difficult to answer these questions at times. It can be difficult to self-diagnose the aches and pains we all feel (particularly, for newer runners). Even more experienced runners may question when to push and when to rest. Injuries can be confusing, and it can be surprisingly difficult to tell if we’re really injured and even where the injury really is located.

Although sometimes a challenge, knowing why you’re in pain is actually the most valuable knowledge there is for treating the root cause of the problem. The most important thing to understand is that getting to the bottom of your pain is the key in relieving it….permanently.

For example, treating your knee may not help to eliminate the pain if it’s actually your hip or low back that is the real source of the pain. Just to make things even more confusing, your pain might not even point to an injury in the first place! Often, we may experience pain that is fleeting and that disappears on its own or is referred from an entirely different part of the body.

Understanding the difference between a one-off pain and a chronic debilitating type of pain is absolutely crucial. If you don’t pay attention to the pain and it really is pointing to an injury, then you might end up exacerbating the injury and/or injuring your body even worse. This can lead to an extended time away from training with a prolonged rehabilitation and recovery.

4 Steps to Identify if you need to engage in a Formal Rehabilitation Protocol or just Rest:

  1. When it comes to pain, listen to your body. Your body is sophisticated and complicated. Its ability to signal injury in the form of discomfort and pain cannot be underestimated. Pain is a potential warning signaling a problem. If we listen carefully enough, our bodies will inform us of our ailments. When it comes to knowing if we’re injured or not, we have to listen. Another way to look at it is as a trust, but verify approach. The pain should give you pause.
  1. Look out for any signs of injury: swelling; discoloration; temperature spikes; trouble walking; difficulty placing pressure on the painful area; and sensitivity to touch. These are all indicators that something is wrong and a more formal rehabilitation approach may be indicated.
  1. If you feel pain for long durations of time (hours to days versus minutes), something is most likely wrong. Don’t make the mistake of believing your pain will disappear on its own. Listen to your body and make a decision to address the pain. Don’t continue to ignore it.
  1. If you find that the pain is not improving on its own and you are experiencing other symptoms of injury (such as swelling, tenderness, and/or changes in movement patterns), then it’s time to figure out exactly what type of injury you’ve sustained. Is this an overuse injury that has slowly creeped up on you? Was pain caused by a specific episode such as a fall? Start by analyzing the types of activities you’ve performed. Think about when the pain occurs and what activities is the pain associated with. Be cognizant that most running related injuries are overuse in nature. This means that there is likely an exacerbating mechanical cause. The actual painful structure may or may not be the associated with the root cause of the injury. Often, overuse injuries are due to a muscle or strength imbalance somewhere else in the kinetic chain which can lead to pain and injury in different areas. This can also be true when poor running mechanics lead to pain or dysfunction.

Understanding injuries and pain can be tricky. It may seem impossible to identify either the cause of the pain or its location, but one thing is certain: it cannot be ignored! Listen to your body and make a decision to get the help you need. Take action. Analyze your activities, stop doing those that you think may be detrimental, and seek professional help if you need it. (If you are unable to determine the reason for the injury, please seek a professional physical therapist in order to establish the exact cause and potential treatment needed.)

Given the complexities of the human body, it can be difficult to determine the root cause of the injury. However, most overuse injuries have very common patterns of dysfunction. Treating according to well documented patterns is often all one needs to recover and get back to running pain free and safely. Formal medical intervention is not always needed or feasible.

Angie Spencer (RN and Certified Running Coach), Trevor Spencer (co-host of the Marathon Training Academy Podcast), and I created the Resilient Runner Program to help you manage and self-treat many of the most common running related injuries and painful areas. This program uses common patterns of dysfunction as a guide to help you self-treat most running related issues.

More specific strategies to help you determine the cause of your injury along with more thorough treatment and prevention strategies for those suffering from overuse injuries are covered in the program, which is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

What’s Inside the Resilient Runner Program:

  • Guidance on preventing and self-treating common running related injuries, including Hip Flexor Pain, Runner’s Knee, IT Band Syndrome, Piriformis Syndrome, and more!
  • Specific guidelines on when and how to return to running after experiencing an injury.
  • Rehabilitation guides with step-by-step photos demonstrating recommended exercises.
  • Step-by-step instructions on how to apply Kinesiological tape.
  • Downloadable podcasts, videos, and more!

If you’re tired of ongoing aches, pains, and injuries, learn how to become a resilient runner so that you can continue to train and compete in order to meet your goals!

I WANT TO BE RESILIENT!

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Good can be Great

Have you ever heard the following saying? “Don’t let great be the enemy of good.” We can often fall into this trap when considering our heath and aging successfully. If we can’t do something perfectly, then we just don’t do it.

However, this is exactly the wrong type of thinking. Successful aging is a worthy goal for all of us to strive toward. To be successful in the aging process, great initiative is necessary as we are solely responsible for our health.

Each person’s journey will be different. It’s not just about the destination. The journey is an evolving process. There will be starts and stops, ups and downs, and twists and turns. Focus on being consistent and making better choices. You don’t have to be perfect…Good can be great! As you make choices in your journey, focus on habits that over time will lead to successful aging.

5 Habits to Help You on your Journey to Aging Well: 

Walk Daily 

A walking routine can help you to manage each of these critical components to successful aging including: physical health; mental health; emotional health; community; and finances (particularly, if leading a healthy lifestyle helps you to avoid the ever growing costs of health care).

Walking has many benefits including:

  • Lowers the risk of heart disease, stroke, and diabetes.
  • Lowers your risk of cancer, including breast cancer.
  • Improves circulation and blood flow to the entire body.
  • Releases stress reducing hormones.
  • Releases hormones that can control blood sugar levels for up to 24 hours. This helps to reduce your risk of diabetes while keeping your energy levels stable throughout the day.
  • Keeps your mind sharp and reduces your risk of Alzheimer’s disease and dementia.
  • Boosts your immune system.
  • Improves sleep quality.

Maintain your Strength

Strength training is critical as you age. All muscle fibers show some decline as we age although the fast twitch (Type II) fibers show the most decline. Strength training is a critical component to maintaining and strengthening Type II muscle fibers. The stronger you are, the more resistant to injury you will be. Most importantly, you must maintain adequate strength to insure the ability to be independently mobile.

Maintain your Balance

Balance is critical to safe mobility. Assuming you have the strength to be mobile; you must also have adequate balance to be safe when moving around. Without adequate balance, you increase your risk of falling or injury.

Focus on your Mental Health 

Regardless of age, it’s important to remain engaged and mentally sharp through constant and varied mental stimulation. This means stay engaged by turning off the television and playing a game or reading a book instead. Better yet, join a book club so you can discuss your latest read with friends.

Other activities to keep mentally challenged include taking an online course, learning how to paint or play a musical instrument. Challenge yourself.

Proper nutrition and exercise also have an impact on your mental health and can help to prevent depression, Alzheimer’s disease, and dementia.

If you are hard of hearing, get appropriate help. Research has shown that a loss of hearing has a direct correlation to isolation, depression, dementia, and mental decline.

Focus on your Emotional Health

Active engagement in your community is a critical part of successful aging. People find community in a variety of ways including family, friends, church, civic organizations or volunteer projects. Others may choose to continue to work.

Remember to share the love. Research clearly notes that those who are more loving and caring tend to live longer and healthier. Be generous with the knowledge and wisdom that you have acquired throughout the years. Love others and purposefully share that love.

Research also validates the importance of friendship in living a long and meaningful life. Many argue that a sense of belonging and purpose combined with a strong social support system will have more influence on the aging process than more traditional factors such as diet, weight control, and exercise.

The importance of having strong meaningful friendships cannot be understated. Research continues to validate that friendship is a key to longevity and avoiding heart disease.

There are many aspects to healthy aging. Maintaining psychosocial support and friendships along with independent mobility and cardiovascular health are key components that can insure you’re living a successful purposeful life. Each person’s journey is different and unique.  We are all capable of successfully aging if we take the initiative and are intentional about the process.

Trying to make something great can actually prevent us from making it just good. Instead of pushing yourself to something impossible and getting nowhere, accept good. You are in control of your journey, so enjoy the ride!

This article appeared on Smart Strategies for Successful Living:

https://www.agegracefullyamerica.com/good-can-be-great/

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My Top 3 Videos on How to Self-Treat Knee Pain

Knee pain is a common complaint among exercisers and non-exercisers alike. So often the actual cause of the knee pain is actually a muscle imbalance elsewhere. Weakness in the hip musculature, particularly the deep hip external rotators muscles, is a common contributing factor for knee pain.

In the following videos, I demonstrate different exercises designed to specifically strengthen your hip and lower leg in order to address muscles imbalances common with knee pain. Addressing these muscle imbalances can lead to the permanent resolution of your knee pain and symptoms.

My Top 3 Videos to Self-Treat Knee Pain:

The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain – The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively. In this video, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

How to Use the Clamshell Hip Exercise to Treat Knee Pain – Knee pain is the most common running related injury. The root cause of many of the most common knee related issues is hip weakness. One of the best ways to treat many common running aches and pains is to focus on strengthening these muscles which include the gluteus medius, the tensor fascia latae, and the other deep hip rotators. In this video, I demonstrate how to perform the clamshell exercise. It’s an excellent non-weight bearing exercise to work on hip rotator strength which will directly affect knee stability.

A Barbell Knee Stability Exercise for Runners – In this video, I demonstrate how to perform an advanced exercise known as the clock or star drill. It’s an excellent exercise to work on knee stability and balance while specifically focusing on quadriceps and hip strength.

If you’re interested in more thorough guide on how to self-treat knee pain, check out the Resilient Runner Program. This is the perfect guide to help you take control of your health and fitness as well as self-manage common aches, pains, and injuries. Even if you’re not a runner, this program is appropriate for those who love to stay active and want to enjoy a healthy lifestyle.

I WANT TO BE RESILIENT!

If you have a question that you would like featured in an upcoming video or blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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Becoming Resistant to Running Injuries

https://www.marathontrainingacademy.com/becoming-resistant-to-running-injuries

Marathon Training Academy

November 14, 2020

In this podcast interview with Angie Spencer (RN and Certified Running Coach) and Trevor Spencer (co-host of the Marathon Training Academy Podcast), we discuss how you can become more resistant to running injuries. Topics include: key ways that people can prevent injuries from occurring in the first place; what type of strength training runners should be doing; and how to differentiate between discomfort and pain and when to seek help. Listen to the podcast

Disclaimer: This blog post and podcast are not meant to replace the advice of your doctor/health care provider, or speak to the condition of one particular person but rather give general advice.

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My Top 3 Most Popular Videos

Due to the COVID-19 pandemic, more and more people are realizing the value of taking control of their health care and personal well-being. In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively. We must get to the root of the issue instead of placing a Band-Aid over it. We must realize that our individual health is our responsibility. We cannot rely on others to make decisions for us. Our present health care system in America is not designed to help you optimize your health–that is your job!   

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively.

I created a YouTube channel in 2015, and I have been adding videos ever since in order to show you a variety of different things including my favorite tips and tricks, how to properly perform exercises, and how to use mobility bands and cupping.

The following videos are my most popular, but I encourage you to take a look around on my channel to see what is most pertinent for you and be sure to subscribe. Also, please let me know if there is a specific topic or condition that you’d like me to address in an upcoming video.

My Top 3 Most Popular Videos:

How to Use Shoulder Pulleys to Regain Shoulder Motion – Shoulder pulleys are an excellent way to use active assistive motion to regain motion in the shoulder post injury or surgery. In this video, I explain the basics of how the shoulder pulley works. They are frequently utilized early in the rehabilitation process to not only help regain motion, but to also promote blood flow which aids in the healing process.

How to Properly Perform Pendulum Exercises – In this video, I explain the basics of how to properly perform pendulum exercises. Although these exercises are basic, they are typically performed incorrectly by utilizing active motion instead of a passive motion. Pendulum exercises are commonly utilized after rotator cuff repair, sub acromial decompression surgery, collarbone fracture and/or surgery, total shoulder replacement/total shoulder arthroplasty, and frozen shoulder (adhesive capsulitis).

How to Use an Exercise Ball to Improve Posture and Treat Shoulder, Neck, and Back Pain – In this video, I demonstrate how to perform I’s, T’s, and Y’s exercises on an exercise ball in order to address lower and mid trapezius and scapula muscle weakness. Poor posture (due to poor thoracic mobility) and poor scapular muscle strength are often major contributors to neck, shoulder, and upper back pain.

Thank you for supporting The Physical Therapy Advisor! If you have a question that you would like featured in an upcoming video or blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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How to Perform a Key Lower Leg Stability Exercise

Weakness in the deep external rotation muscles and poor lower extremity single leg balance are commonly associated with many lower extremity overuse injuries. A simple and effective exercise to improve strength, balance, and general stability of the deep hip external rotator muscles is the clock exercise (also called the star drill).

The important points to remember in this exercise are to keep the stance knee unlocked (the leg you are standing on) with the patella (knee cap) slightly externally rotated (usually pointing towards the 3rd or 4th toe). The rotation must come from the hip, NOT the ankle. The stability of the hip and activation of the deep hip external rotators needs to be the primary focus.

Slowly touch the ground very gently with the opposite leg. The amount of pressure touching the ground should be so slight that if there were a package of crackers taped to the bottom of the foot the crackers would not break. Performing the drill on a balance pad will significantly increase the difficulty level of the exercise.

In the following video, I demonstrate how to use a balance pad to perform the clock exercise, a key lower leg stability exercise for treating knee pain, hip pain, and foot and ankle related issues as well as balance.

CLICK HERE TO WATCH NOW

For additional videos on my recommended exercises to increase hip strength and stability, be sure to check out:

For prevention strategies and to learn more about on how to self-treat the most common lower extremity overuse injuries, be sure to check out the Resilient Runner Program, which is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

Have you performed the clock exercise before? If so, what was your experience like? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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How to Perform a Key Hip Stability Exercise

Hip pain, knee pain, and even foot pain (such as plantar fasciitis or posterior tibialis syndrome) can have an associated hip external rotation weakness. An important yet often overlooked component to proper lower extremity stability is how the deep hip external rotator muscles need to work along with other hip external rotators and hip abductors, such as the gluteus medius, to insure proper lower extremity positioning when the leg is in full weight bearing. Particularly, in a single leg stance position during walking, running, skipping or landing from a jump as the leg accepts full weight bearing while the opposite leg is in swing phase.

The deep hip rotators, also known as the short external hip rotators, are a group of muscles consisting of the superior and inferior gemelli, obturator internus, quadratus femoris, and the piriformis. This group of muscles is extremely important for stability of the body, pelvis, and leg as the leg/foot initiates full ground contact.

Weakness in these muscles is often associated with many of the more common lower extremity overuse injuries:

  • Foot injuries: Plantar Fasciitis, Achilles Tendinitis, Posterior Tibialis Syndrome
  • Knee injuries: Patella Femoral Pain Syndrome (PFPS), Iliotibial Band Syndrome (ITBS)
  • Hip related issues: Piriformis Syndrome, Hip Bursitis,  Hip Impingement

A simple and effective exercise to improve strength of these muscles is the standing hip 3-way exercise. The important points to remember in this exercise are to keep the stance knee unlocked and in a “soft” stance with the patella (knee cap) slightly externally (laterally) rotated (usually pointing toward the 3rd or 4th toe). The rotation must come from the hip, NOT the ankle. The stability of the hip and activation of the deep hip external rotators should be the primary focus.

In the following video, I demonstrate how to use an exercise band to perform the standing hip 3-way exercise, a key hip stability exercise for treating hip pain, knee pain, and foot and ankle related injuries.

CLICK HERE TO WATCH NOW

For additional videos on my recommended exercises to increase hip strength and stability, be sure to check out:

For prevention strategies and to learn more about on how to self-treat the most common lower extremity overuse injuries, be sure to check out the Resilient Runner Program, which is designed to help YOU meet YOUR training goals by insuring you have the tools to avoid injury, recover quickly, and train at a peak level.

Do you suffer from hip, knee or foot pain? If so, hip external rotation weakness may be part of the reason for the ongoing pain as you overload and overuse other structures trying to gain extra lower leg support. Additional discussion can help others to manage this condition more effectively. Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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3 Easy Exercises to eliminate Wrist and Elbow Pain

Hand, wrist, and elbow pain is all too common (particularly, with computer, tablet, and phone use). Pain in any one of these locations affects all of us from time to time. The two most likely reasons for developing hand, wrist, and elbow pain are from overuse and poor posture.

Poor wrist, shoulder or thoracic mobility is also commonly related to hand, wrist and/or elbow pain. If the wrist cannot flex or extend properly, it not only causes wrist pain, but excessive stretching of the forearm muscles and strain on the elbow (possibly leading to pain). Poor shoulder or thoracic spine mobility can also cause excessive strain on the elbow, wrist and/or hand.

In this video post, I describe three easy exercises to help you quickly eliminate pain in your hand, wrist, and elbow. I demonstrate two simple stretches with an easy variation to improve their efficacy and teach you how to easily improve your hand and wrist strength using a simple rubber band.

CLICK HERE TO WATCH NOW

Posture plays a critical role in the positioning of your extremities with movement and even when sitting (including office and/or computer work). Improper posture combined with poor ergonomics is a top reason to develop not only elbow pain, but also neck, upper back, shoulder, and wrist pain. Regardless if the activity is weightlifting or typing, your posture matters!

For additional ways to easily improve your posture and reduce pain in the arm/hand as well as the neck and shoulder, be sure to subscribe to my e-mail list to gain immediate access to My Top 8 Stretches to Eliminate Neck, Upper Back, and Shoulder Pain for step-by-step exercise instructions and photos.

Hand, wrist, and/or elbow pain can be debilitating and limit your ability to exercise, work on the computer or even use your phone. Be proactive in your care and management. If the pain persists, seek additional help. Don’t let the pain linger. The longer it’s left untreated, the more potential for harm and damage which potentially could lead to a longer recovery. The American Physical Therapy Association (APTA) is an excellent resource for learning more about physical therapy as well as locating a physical therapist in your area.

Do you have any other favorite exercises or stretches to reduce hand, wrist or elbow pain? Please leave your comments below.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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5 Strategies to Improve Your Physical Resiliency

Why do some people age well while others do not?  The answer may in part lay in a person’s resiliency.  Resiliency is defined as an object’s ability to return to an original form or position after being bent, compressed or stretched.  When this definition is applied to a person, it gives us a clue as to why some people recover quickly after illness or injury.  This more scientific definition helps us understand why resiliency is nothing more than your own margin for error in life.  The greater margin for error you have, then the less likely something catastrophic will occur.  Continue Reading to discover 5 Strategies to Improve Your Physical Resiliency.

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The Clamshell: A “go to” Exercise for Treating Foot, Hip, and Knee Pain

Do you suffer from foot, hip or knee pain? If so, hip external rotation weakness and poor single leg balance may be part of the reason for the ongoing pain as you overload and overuse other muscle groups in order to gain extra lower leg support. Weakness in the deep external rotation muscles is commonly associated with many lower extremity overuse injuries.

Injuries commonly associated with hip weakness include:

  • Foot/ankle injuries such as plantar fasciitis, Achilles tendinitis or posterior tibialis syndrome.
  • Hip related issues including piriformis syndrome, hip bursitis, and hip impingement.
  • Knee injuries such as Patellar Femoral Pain Syndrome (PFPS) and Iliotibial Band Syndrome (ITBS).

The deep hip external rotator muscles need to work along with the hip abductors (such as the gluteus medius) to insure proper lower extremity positioning when the leg is in full weight bearing. (Particularly, in a single leg stance.) One leg bears the full weight while the opposite leg is in the swing phase while walking, running or skipping.

The deep hip rotators (also known as the short external hip rotators) are a group of muscles including:  the superior and inferior gemelli muscles; obturator internus; quadratus femoris; and the piriformis. This group of muscles is extremely important for stability of the body, pelvis, and leg as the leg/foot initiates full ground contact.

The clamshell exercise is a commonly prescribed exercise designed to target the hip abductors and hip external rotators. However, this exercise is often performed incorrectly or ineffectively. 

In the following video, I demonstrate my preferred method of performing the clamshell exercise in order to insure optimal effectiveness.

In order to engage the deep hip rotators, you should feel the muscles working deep into the buttocks and directly behind the greater trochanter (the hard bone that pokes up at the top of the hip).

This exercise should be performed very slowly. I advise a count of 5 seconds up, a 5 second hold, and then a 5 second slow return to the starting position for at least 10 repetitions.

If you aren’t feeling the deep hip rotators activate, then you may need to reposition your legs. Usually, repositioning the knees and moving them up toward your head into a more fetal position will do the trick.

CLICK HERE TO WATCH NOW

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!